Final Autopsy and Toxicology Report

[sabpascu]

Also just out of curiosity, would sedatives like GHB or chloroform still be in the body after it has been in a water tank for several weeks? Some here have said that scientifically some of the lab work may be questionable so long after the individual has been lying in water. I would think that some of those would have such a short half life that they could be out of her system by the tank she was on the roof/in the tank.

Chloroform, guys? While acute exposure to chloroform wouldn't be detectable in an autopsy as chloroform leaves the body quickly, chronic intoxication with chemicals that break down into chloroform in the body will show up on an autopsy tho, you can find it in the liver an kidneys, but that's not the case here.
The portrayal of chloroform in movies - bad guy takes a rag, sticks it into chloroform and tries to smother someone from behind, they smell the chloroform and pass out - is extremely inaccurate. A 3 minute exposure to chloroform could lead to vertigo and dizziness at most. And that's like 3 minute exposure, not 3 seconds. About 10 minutes in conjunction with the administration of other kinds of drugs such benzodiazepines could render a person unconscious. Now you can administer benzodiazepines in various ways: with alcohol (there was no alcohol in her blood, there is alcohol in her bile but that doesn't mean she had alcohol recently, means she had a drink about one day before), IV injection (would have been signs of it) or pils...(no pills in gastric content).

GHB would have been detectable in blood or urine. However, someone would have had to hide it while offering her a drink. Or give her a ton of pills. (there were no signs of pills in her stomach contents) So GHB is very unlikely to have been used.
Also half-life doesn't work like that. Half of it being used by the body doesn't mean it's gone. There's still some left, considering the fact you need a larger amount to render someone unconscious plus there's metabolites that can be detected.

We were not in on the autopsy, and it was witnessed by the investigating officers who were hardly thorough. Who is to say that there were marks that went unrecorded? Or to say that the look for marks was even comprehensive? The report speaks only to what the coroner wants to be known or recorded.

An autopsy report is usually a pretty standard document as in it has a a list of aspects that need to be taken into consideration. So it's not just the medical examiner saying: Oh, her thyroid is unremarkable, that sounds good, let's put that in. There are some predetermined things he needs to look at and note so that anyone who reads it gets a good idea of the condition the body is in.

Case in point, look at the actress Natalie Wood. She supposedly accidentally drown after "falling" off a boat in the 80's. Just last year her case was reopened as suspicious after it came to light that she had visible contusions on her body that were somehow overlooked by the coroner.

I'm pretty sure there isn't someone whose job is specifically to review old autopsy reports and pictures. Pretty sure the reopening of the case had something to do with a confession or a tip because that's usually the case.

Who is say that EL was not somehow rendered unconscious or immobile by either partial aspyhxiation, chloroform, or some other drug that was not tested? They hardly ran all the drug tests they could have; was she even tested for poisons. She would not have struggled or resisted. Yes, this is all far fetched but no more so than her climbing into the tank of her own accord after suffering a psychotic break.

Ummm...people do all sorts of crazy stuff if they're mentally ill. Like AAAALL sorts of crazy stuff. Their view of the outside world isn't as we see it in those moments, they suffer from delusions, hallucinations...

 

[Conductor71]

An autopsy report is usually a pretty standard document as in it has a a list of aspects that need to be taken into consideration. So it's not just the medical examiner saying: Oh, her thyroid is unremarkable, that sounds good, let's put that in. There are some predetermined things he needs to look at and note so that anyone who reads it gets a good idea of the condition the body is in.



I'm pretty sure there isn't someone whose job is specifically to review old autopsy reports and pictures. Pretty sure the reopening of the case had something to do with a confession or a tip because that's usually the case.



Ummm...people do all sorts of crazy stuff if they're mentally ill. Like AAAALL sorts of crazy stuff. Their view of the outside world isn't as we see it in those moments, they suffer from delusions, hallucinations...

Ummm...I am aware of all this, and I did not suggest that someone sat around looking through autopsy archives.<mod snip>

My point is that there is still quite an element of subjectivity to coroner rulings. This is evident in the The National Association of Medical Examiners' Guide For Manner of Death Classification. Deciding between manner of death is hardly scientific. The guideline state that manner is undetermined info pointing to one manner of death is no more compelling than another. A medical examiners conclusion is still an opinion. We all here simply disagree on what comprises "compelling" evidence.

http://www.charlydmiller.com/LIB03/2002NAMEmannerofdeath.pdf

 

[Conductor71]

If the family truly believed it murder, they would not be suing the hotel. Perhaps we could respect their wishes.

edited to add: <mod snip> Within the rules of WS, and using only the evidence we have, please explain how this happened, and just as importantly, why you think this is the case, despite all of the expert evidence to the contrary.

How can you know what the family is thinking? They are in fact on record as disbelieving the coroner's ruling.

They could be suing the hotel for any number of reasons which we do not not know. From my understanding, justice is commonly sought in civil court when family members are not content with a vague autopsy or investigation because they have little or no other legal recourse. The burden of proof is on a family to disprove with a preponderance of evidence that someone else besides their daughter is at fault. This is outrageous considering potential evidence is long gone or that law enforcement was not held to any such similar burden in proving how it was an accident in the first place. Imagine the legal costs. Filing a wrongful death suit, I believe, is the only way to assure that the case is reopened and comes under more scrutiny. Police are not obligated to reopen cases from what I understand. Maybe some or our legal experts could step in to clarify?

 

[Nickfalzone]

That has been my assumption as well regarding their case against the hotel. At the end of the day, we will probably never know exactly what happened that night unless, as Sabascu said, someone comes forward with further information like in the Natalie Wood case, or the family extracts further information through the judicial system. I still think there is possible undisclosed or even uninvestigated evidence in the electronic communication records, but that is also just speculative based on my lack of faith in the LAPD's thorough investigation skills.

 

[Userid]

There are 3 things I'd like to address, if I may:

First, just because Elisa's father doesn't believe in the final determination in the autopsy report, that in no single way makes the determination inaccurate.

Second, for everyone desperate for the police report, I'd just like to throw this out there: even if you did get your hands on it (which, to my understanding, will be next to impossible), you will most likely remain just as unsatisfied as you were when the autopsy report was released.

Third, how anyone can interpret the video as Elisa being scared in any way is truly beyond me -- and I don't say that to be mean-spirited; but I really see nothing that would lead me to believe that to be the case. I'll refrain from giving reasons, as I've already done so in the video thread; reason being, I don't want to derail this thread and get it closed.

 

[Nickfalzone]

Third, how anyone can interpret the video as Elisa being scared in any way is truly beyond me -- and I don't say that to be mean-spirited; but I really see nothing that would lead me to believe that to be the case.

Eye of the beholder, I suppose. As countless others have suggested both on this board, the youtube video comments, and elsewhere, Elisa definitely seems calm as she walks into the elevator, then stands in the back, waits, appears to be alerted by something, then hides in the front corner of the elevator and peeks out as if she is afraid either someone is there or someone has stopped the elevator from closing. It is one of those things that we'll never know, whether it was a psychological problem or something outside that truly set her off, but as it stands there is no answer one way or another, beyond our own interpretations.

Also, one can dismiss the father's thoughts on this, but one can also take them as they are, a father that was not satisfied with the conclusions of the investigation, just as many of us feel. At the end of the day, everyone has a right to their opinions on the case, including the members here and of course her own father.

 

[thesetup85]

I think the opinion on this thread is divided between two poles.

1) People who believe that since the toxicology is clean and that the autopsy suggests no bodily harm, hence Ms. Lam entered the tank on her own.

2) People who believe that toxicology and autopsy do not cover all the scenarios and foul play still cannot be ruled out (for example a choke hold on the victim will render her temporarily unconcious without any significant bruising or that she could have been forced into the tank at gunpoint, etc).

I can see where people on 1) are coming from. The lack of any glaring evidence of foul play coupled by Ms. Lams behaviour in the Elevator indicating a psychotic attack, are very convincing factors.

Yet I can also see where people in 2) are coming from, looking at the supposed sequence of events:

Ms. Lam makes her way to the roof (where the door happens to have a non functioning alarm and happens to be unlocked).
Gets on top of the tank (which happenes to be accessible via an adjacent shed).
Opens the tank lid (which happenes to be unlocked).
Strips and tosses her clothes them in the tank, and then climbs in (all while it is dark).

These events seem to have been carried out in a strictly organized manner, yet supposed to be performed by a person suffereing a severe anxiety attack and/or hallucinations. This leaves one thinking if another party was involved in this sequence of events.

I personally see merit in both 1) and 2) and am on the fence. Maybe if the police report was made available, more light could be shed on this case. Without further evidence, its hard to establish with certainity, what really happened.

Thanks for reading.

 

[sabpascu]

Ms. Lam makes her way to the roof (where the door happens to have a non functioning alarm and happens to be unlocked).
Gets on top of the tank (which happenes to be accessible via an adjacent shed).
Opens the tank lid (which happenes to be unlocked).
Strips and tosses her clothes them in the tank, and then climbs in (all while it is dark).

These events seem to have been carried out in a strictly organized manner, yet supposed to be performed by a person suffereing a severe anxiety attack and/or hallucinations. This leaves one thinking if another party was involved in this sequence of events.



Thanks for reading.

I personally do not think it's impossible for a person who is having a bipolar disorder episode to do all of that in such an organized manner. But I do see how some people think it's impossible for that to happen and I think these people have never seen a person exhibiting such symptoms. Mental impairment doesn't necessarily involve physical impairment, but it involves strange behavior and I find stripping naked and getting into a water tank a little bizarre.

People's brains react in different ways, some will present a profoundly agitated state and bizarre behavior, some will not move at all and not react to any stimulus.

 

[Host]

One of the common ways of accurately determining that suffocation methods has been employed is by finding what can be a result of 'non'-violent asphyxial death. In strangulation cases, the following could be seen: Face swollen and blue, lips blue, eyes opened, eyeballs bulging out, pupils dilated, tongue swollen and between the teeth, blood stained froth from mouth to nostrils. The discharge of scant secretions being sero-sanguineous and usually of a reddish-brown color is a result of solidified carbon dioxide. But if we were to assume it was induced by the submersion/immersion of liquid, then there would be particular bruises and traces of trauma found in the skin, bone, nail, nailbed, tendon, pulp, and the padded components of the fingertips to suggest she was alive after falling within the cistern (which would mean she didn't struggle before drowning, logically), making suicide all the more probable. But we know that the hotel's water supply would be the least practical solution.

This report raises more questions than it answers. Why were samples collected for a rape kit and fingernail kit but never tested? How can they use the toxicology report when insufficient tissue or blood samples were tested? The most glaring question is why the coroner changed their ruling from undetermined to accidental? Hopefully the wrongful death lawsuit will answer some of these questions.

If, indeed, the evidence kit had never been used for further examination, then we may be missing fundamental pieces that which would hinder exertion relating to the violence, if there were none. And if the ruling had been changed to 'accidental', then it's possible she may have died elsewhere which would strongly indicate a murder.



I have a theory... what if it wasn't sexual assault but death during consensual sex?

 

[Montjoy]

I have a theory... what if it wasn't sexual assault but death during consensual sex?

COD was drowning, and there was no evidence of sexual assault or activity. If she went into the tank with someone else and had sex there, why would she put all of her clothing in the tank? Drowning isn't instantaneous; why were there no signs of struggle on her body? How was her supposed paramour able to get out of the tank? With respect, nothing about this theory is remotely plausible.

 

[Host]

COD was drowning, and there was no evidence of sexual assault or activity. If she went into the tank with someone else and had sex there, why would she put all of her clothing in the tank? Drowning isn't instantaneous; why were there no signs of struggle on her body? How was her supposed paramour able to get out of the tank? With respect, nothing about this theory is remotely plausible.

Suggesting that this was done within the cistern would make it the least plausible. But if her death took place outside, it would begin a likely thread. Unusual extenuating circumstances during consensual activity may be voluntary, and can be quite difficult to infer after the body had been found decomposing in water.

 

[Nickfalzone]

Suggesting that this was done within the cistern would make it the least plausible. But if her death took place outside, it would begin a likely thread. Unusual extenuating circumstances during consensual activity may be voluntary, and can be quite difficult to infer after the body had been found decomposing in water.

Your theory neglects to account for the strong evidence that she did in fact drown. That being said, it could be that: a.) she was drowned elsewhere and was put in the tank, or b.) asphyxiated to the point of loss of consciousness (either voluntarily or involuntarily), then put in the tank to drown. No real evidence for either one, but they are technically possible. The fact that she did not appear to have any signs of attempting escape, such as bruises on legs or fingernails damaged, is an interesting piece of evidence that as you said could imply suicide or some other cause of death besides accidental.

 

[Host]

Your theory neglects to account for the strong evidence that she did in fact drown.

It has only been opinionated, which is merely conclusive, from an outwardly view that she may have drowned, given the obvious circumstances. The autopsy shows that the parenchyma had postmortem abdominal distension and hydropsy, which is caused by the swelling. And at postmortem state, the body will produce gas by putrefaction before collapsing in on itself and drying out. None of which is necessarily caused by the exertion of liquid (the body will gain resilience regardless if it is 'drowned' or not). So it's difficult to say whether the cause of death really was by drowning without insisting. I would hardly call it strong evidence.

Side Note: Could this be where EL's parents share their suspense?

 

[Montjoy]

It has only been opinionated, which is merely conclusive, from an outwardly view that she may have drowned, given the obvious circumstances.

Could you explain this? It doesn't make any sense. E.g., the first part of the first sentence -- what is it that has 'only been opinionated', and what does it mean for anything to be 'only opinionated'? I'm sorry, but that is not intelligible.

What does it mean to be 'merely conclusive'? If something is conclusive, well, that means that it has been explained. Game over; merely is not a meaningful adverb. Conclusive is an absolute, a goal, and so what you are writing is akin to saying that something is merely perfect. In English, at least, a conclusion suggests that the final answer has been reached.

And while we're at it, what is an 'outwardly view' in the context of what you have written? Honest question, I can't imagine anyone knows what you mean.

Thanks in advance for your explanations here! Be well.

 

[Host]

Opinionated, meaning it is only an opinion. Not a fact.

Merely conclusive, meaning an argument is hardly substantial.

Sent from my LGMS500 using Tapatalk

 

[Host]

It's not a fact where it is stated as an opinion. I know these autopsy reports may look BIG and scary to most people, but they are not always consistent with the cause of death. It is simply a thesis. It is a theory placed on trial within the court.

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[sophiebelle]

I suppose parts of an autopsy is an opinion. You can't refute a toxicology report, but look at the Alfred Wright case on WS. His mother is refuting everything and got a 2nd opinion. Which one is right? Would a jury believe one case over another. In many trials, the autopsy is discussed and you can choose to believe the coroner or ME or not.

 

[sabpascu]

The discharge of scant secretions being sero-sanguineous and usually of a reddish-brown color is a result of solidified carbon dioxide.

What? They found dry ice in her throat?

 

[jinkies!]

<modsnip>

Anyway, so let me run all this by and please correct me where I've erred.

Elisa Lam went to Hotel Cecil, on a fairly dangerous side of LA. She had no real itenerary, although I'd be interested to see the security tapes covering the entrance/exit and see when and if she left. (I know she says Italians or something were following her, but social media usually brings out the ego in people, but she said it was at nightclubs?) I'd be intersted to know why her parents would let her go, except to not want to upset her even worse than she was, except that she told them of an intenerary. She took lots of medications, and she was probably at least moderately depressed. Her tumblr seems to indicate she was capable of such deep thoughts. She was not taking the medications right, probably. She also seemed to suffer from insomnia.

We see her in a red jacket, with a shirt underneath, and gym shorts around 1-2AM on elevator secuirty footage the night/day she disappears. After much reading and viewing, I feel she is not scared of anyone (I'll quickly direct dissenter's attention to the loopy path her elevator-pressing-finger takes on its way to the buttons). She is staying on the fourth floor, and the footage from the 13th. It is a permanent-resident floor. I assume there is no footage of her going up in the elevator? If not, I suppose she walked up the stairs. That's a long way, and a silly thing to do, but I feel she was maybe having an episode of insomnia, and I do not consider it odd under the circumstances. She goes out of the elevator and gestures, perhaps to someone. She certainly does preen in the mirror. She also hides in the elevator, I think to scare someone, in a flirty game, and the direction that she hid makes me surer. But then again, maybe her insomnia mixed with her medications and she was just imagining. I would be interested to know how many people are up at 1-2AM on a Thursday night/Friday, on the fourth floor, and on the lobby floor. But she walks off in the other direction at the end, so I think we can rule that out entirely, to a large degree.

She exits and all we know next is that she was declared missing. Dogs were called, perhaps days later, but they plausibly could have missed her if she was in metal. Now, from here, we could assume she went back to her room, or she was still wandering and found someone to hang out with or something to do, or she went striaght up to the roof and never left.

Three? months later, she's found in the tank after residents complain of low water pressure. Her clothes are removed, but her watch is still on. Now, her clothes, are they the same red jacket and gym shorts we saw in the elevator video? Forgive me if I overlooked this detail in some thread. Final Autopsy rules cause drowning, accidental. There's a ladder, so there's easy access. She can fit through the hatch, but there's no marks on her body, save a scar on one knee and an abraision on the opposite. Lots of signs of decomposition, I assume consistent with the time of death.

There was one, and sorry, first post, and I don't know how to quote yet, where a girl said " (there was no alcohol in her blood, there is alcohol in her bile but that doesn't mean she had alcohol recently, means she had a drink about one day before). So plausibly, since she was probably in the tank in the quasi-morning hours, she could have had a drink that night. Where'd she get the drink anyway, does the security footage reveal anybody with her if she had it in the hotel? If elsewhere, I suppose information may be hard to find, except by a vigilant bartender.

No drugs in the system, except ones expected and prescribed to her. No defensive wounds, even in the nails, which I assume wouldnt have decomposed or been flushed by the current?

SO I guess we'll never know if the hatch was cllosed or open when she was found? Am I right in thinking that you remove the hatch, its not a hinge mechanism? that could be a good detail to have.

I think I covered everything I wanted to, but I probably forgot something. ha, I guess that's enough for now anyway, what time is it...

 

[sabpascu]

Three? months later, she's found in the tank after residents complain of low water pressure. Her clothes are removed, but her watch is still on. Now, her clothes, are they the same red jacket and gym shorts we saw in the elevator video?

I'm gonna assume you meant 3 weeks. Her watch wasn't still on, it was found in the tank with the rest of her clothes which were the clothes she was wearing in the video.

SO I guess we'll never know if the hatch was cllosed or open when she was found? Am I right in thinking that you remove the hatch, its not a hinge mechanism? that could be a good detail to have.

You can still angle it at let's say 45 degrees (basically anything less than 90 degrees) and if she jumped into the tank and let it go at the same time it would have closed behind her.